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PubMed1988

Level of knowledge among adolescent girls regarding effective treatment for dysmenorrhea.

Are adolescent women aware of the relatively specific pharmacologic intervention now available for dysmenorrhea? A multiple-choice questionnaire was administered to 182 adolescent women, ages 14-18 years, to assess the prevalence of dysmenorrhea, the morbidity associated with dysmenorrhea, and the level of knowledge regarding available treatment. Of the study group, 72.7% reported "pain or discomfort" during their period, 58.9% reported decreased activity, and 45.6% reported school or work absenteeism. Of the dysmenorrheic sample, only 15.5% had used a prescription medication and only 14.7% could name any nonsteroidal antiinflammatory agent, except aspirin, as potentially effective in relieving dysmenorrhea. These data suggest that there is substantial ignorance or misinformation among adolescent females regarding effective treatment for dysmenorrhea. The prevalence of school and work absenteeism provides evidence for the continuing importance of dysmenorrhea as a public health problem of this age group. Discussion of effective therapeutic options for dysmenorrhea should be part of routine health care visits for adolescent women.

Absenteeism↗
PubMed1993

A controlled study of the effects of an early intervention on acute musculoskeletal pain problems.

Current conceptions of chronic pain clearly suggest that proper care at the acute stage should prevent the development of chronic problems. Patients (198) seeking help for acute musculoskeletal pain (MSP), e.g., back and neck pain participated in two studies of the effects of an Early Active intervention which underscored 'well' behavior and function compared to a Treatment as usual control group. The quantity of the Early Active treatment was a median of 1 doctor's appointment and 3 meetings with a physical therapist. Study I concerned patients with a prior history of sick-listing for MSP, while study II involved patients with no prior history of MSP. Treatment satisfaction, pain experience, activities and sickness absenteeism were assessed before, after and at a 12-month follow-up. In study I (patients with a history of MSP), the results showed significant improvements for both groups, but virtually no differences between the groups. Similarly, in study II (no history of MSP) both groups demonstrated significant improvements, e.g., for pain intensity and activity levels. However, the Early Active treatment resulted in significantly less sick-listing relative to the control group. Moreover, the risk of developing chronic (> 200 sick days) pain was 8 times lower for the Early Activation group. This investigation shows that relatively simple changes in treatment result in reduced sickness absenteeism for 'first-time' sufferers only. Consequently, the content and timing of treatment for pain appear to be crucial. Properly administered early intervention may therefore decrease sick leave and prevent chronic problems, thus saving considerable resources.

Absenteeism↗
PubMed1995

Home management of sickle cell-related pain in children and adolescents: natural history and impact on school attendance.

Some children and adolescents with sickle cell disease experience frequent painful episodes. To gain information about the natural history of the pain and its impact on sleep and school attendance, we developed a home-based diary system. Eighteen children and adolescents completed 4756 diary days, with an average compliance of 75%. Pain was reported on 30% of days and was managed at home nine-tenths of the time. Girls reported more days with pain than did boys, and age was positively correlated with the length of the painful episodes. The pain affected school attendance and sleep. Patients were absent from school on 21% of 3186 school days, with half of the absenteeisms on days with reported pain. Of the pain-associated absenteeisms, two-thirds occurred when pain was managed at home, and one-third when patients were hospitalized. The average consecutive number of school days missed was 2.7. These findings have implications for developmentally critical activities.

Absenteeism↗
PubMed1994

Pain behavior in industrial subacute low back pain. Part I. Reliability: concurrent and predictive validity of pain behavior assessments.

The reproducibility of overt pain behavior ratings was shown to be reliable between independent observers. In the clinical evaluation of 103 blue collar workers with subacute low back pain (LBP), concurrent validity was high between Behavioural Signs (Waddell et al. 1980) and UAB Pain Behavior Rating scale (Richards et al. 1982). Correlations with pain rated on visual analogue scales (Scott and Huskisson 1976) were generally lower. Behavioural Signs correlated separately with covert pain behavior (general convictions concerning back strength and general health). It seems that subacute LBP patients do not behave as a homogenous group since pain behaviors predicted occupational handicap (absenteeism) in a non-linear fashion. Return to work was best predicted by UAB and covert pain behavior, absenteeism up to 2 years by covert pain behavior. The findings emphasize the potential social implications of overt pain behaviors and the importance of covert pain behavior in maintaining the sick role. The conclusion is that, in secondary prevention, where the main targets are to interfere with somatic deconditioning and sick-role development, a more diversified primary approach may be possible, based on supplementary use of relatively easy observational tests and quick self-reports.

Absenteeism↗
PubMed2006

Chronic pain and reduced work effectiveness: the hidden cost to Australian employers.

Cost estimates of the impact of chronic pain on work have largely focussed on absenteeism, excluding the hidden contribution of reduced work effectiveness to lost productivity. This paper aims to estimate the cost of lost productivity due to chronic pain in Australia, not only in terms of absenteeism but also reduced work effectiveness. Data on chronic pain in Australia and its impact on work were obtained from the 1997 New South Wales Health Survey (n=17,543) and the Northern Sydney Area Pain Study (n=2,092), both of which were population-based and used random-digit dialing sampling methods. This was combined with relevant Australian population and labour force data obtained from the Australian Bureau of Statistics. From this we estimated annual lost productivity costs arising from both chronic pain-related days absent and 'reduced-effectiveness workdays'. There were estimated to be 9.9 million workdays absent due to chronic pain annually in Australia, equating to a cost of AUD 1.4 billion per annum. Under the assumption that reduced-effectiveness workdays affect productivity costs in the same way as lost work days, the total number of lost workday equivalents was 36.5 million, with the total annual cost of lost productivity due to chronic pain estimated as AUD 5.1 billion per annum. In conclusion, while the impact of reduced work effectiveness on days worked with pain on productivity is uncertain, it has the potential to account for the majority of lost productivity costs associated with chronic pain. Interventions which target working despite pain have the potential to significantly reduce lost productivity costs due to chronic pain.

Absenteeism↗
PubMed2006

Predictors of academic performance in a cohort of pre-registration nursing students.

The recruitment, selection and retention of nursing students have become crucial in securing the future workforce required by the NHS. Concerns regarding the academic performance of what is a changing student profile led to an audit being performed to explore the predictive relationship between entry qualifications, age, gender, attendance and academic performance in a cohort of pre-registration Diploma of Nursing students. Data was collated from a cohort of 154 students. Statistical analysis demonstrated that students with higher level entry qualifications performed consistently better than those with lower level qualifications. Mature students, over the age of 26, achieved better average marks in coursework and examinations that their younger peers. Year 1 performance predicted year 3 performance in both examinations and assignments. Non-attendance was shown to have an impact on academic performance with a correlation existing between high absenteeism and poor academic achievement. The findings highlight interesting issues for nurse educators relating to academic student support particularly in first year; recruitment and selection of the most suitable candidates; absenteeism monitoring and curriculum design.

Absenteeism↗
PubMed2004

'Choosing' to work when sick: workplace presenteeism.

Presenteeism is a concept used to describe the phenomenon of working through illness and injury. This paper is based on interviews and focus groups undertaken at three different work sites in New Zealand: a small private hospital, a large public hospital and a small factory. The research suggests that presenteeism is a prominent phenomenon in the lives of workers at these different sites, but the way in which it is rationalised and the factors that foster presenteeism are quite distinct. Exploring the way in which presenteeism links to economic and social constraints and workplace cultures provides insights into these rationalisations. The powerful forces promoting presenteeism tempers the research community's concern with absenteeism. A presenteeism discourse needs to be more prominently articulated to oppose both the absenteeism discourse, and to moderate the views taken by some postmodernist theorists on choice in relation to health practices in workplace settings.

Absenteeism↗
PubMed2002

The economic loss due to treatment costs and work loss to individuals with chronic lymphatic filariasis in rural communities of Orissa, India.

This paper is based on 1 year round case control study to investigate the economic burden, in terms of treatment costs and loss of work to people affected with chronic lymphatic filariasis in rural communities of Orissa, Eastern India. Around three-fourths of the chronic patients have sought treatment for their condition and spent, on average an amount of INR 396 (approximately US$ 8.7) per year. The major component of the expenditure is the cost of medicines. The data on loss of work time due to chronic condition reveal that the total absenteeism to the work is significantly higher among chronic filariasis patients than controls. The total number of working hours spent per day by patients and controls are 4.94 and 6.06, respectively with a significant difference. The total absenteeism and the total number of working hours per day are influenced significantly by disease condition and other personal characteristics, namely age, sex and family type. The chronic patients lose a total of 68 days of work per year, which is equivalent to 19% of the total working time of the year. The present results show that the chronic conditions of lymphatic filariasis pose considerable burden on the patient, family and community.

Absenteeism↗
PubMed1999

Occupational mental health: a study of work-related depression among nurses in the Caribbean.

This study addresses issues of occupational mental health among nurses in the Caribbean. A linear model linking role, work and social factors, stress, burnout, depression, absenteeism and turnover intention guides the research. Data were collected from 119 nurses working for major hospitals located in St. Vincent and Trinidad & Tobago using a field survey. Psychometrically sound instruments with proven cross-cultural validity were utilized in the questionnaire. Descriptive statistics, correlations, and path analysis were used to analyze the data. The results indicated fairly strong support for the proposed model which is tested for the first time among a Caribbean population. Role conflict, role overload and social support predicted stress, which along with social support predicted burnout. Burnout was the sole predictor of depression which in turn predicted both absenteeism and turnover intention. Implications of these findings for research and practice are discussed.

Absenteeism↗
PubMedDate not supplied

Effect of intestinal helminthiasis on school attendance by early primary schoolchildren.

Stool examination of 249 early primary schoolchildren at 2 schools in north-eastern peninsular Malaysia revealed that 73 were infected with Ascaris lumbricoides, 103 with Trichuris trichiura, and 18 with hookworms. Infected children were treated with a single dose of 400 mg of albendazole. The school attendance records during a 60 d period before treatment and 2 consecutive 60 d periods after treatment were examined. The absenteeism rate did not improve more among infected children after treatment than it did among the uninfected control children. The correlation between worm intensity and the number of lost school-days was poor. There was no evidence that intestinal helminthiasis caused school absenteeism among this group of children.

Absenteeism↗
PubMed1997

Effect of organisational downsizing on health of employees.

BACKGROUND: Reduction of personnel by businesses and other organisations (organisational downsizing) is common in Europe, but little is known about its effects on the health of employees. METHODS: We used employers' records to investigate the relation between downsizing and subsequent absenteeism because of ill health in 981 local-government workers who remained in employment in Raisio, south-western Finland, during a period of economic decline (1991-95). Data were separated into three time periods: 1991, before downsizing; 1993, major downsizing in some workplaces and occupations; and 1993-95, after downsizing. We obtained data on sick leave from records kept by the occupational health-care unit in Raisio. We also investigated whether the effects of downsizing were dependent on ten other predictors of sick leave. FINDINGS: There was a significant association between downsizing and medically certified sick leave. The rate of absenteeism was 2.3 times greater (95% CI 2.0-2.7) after major downsizing, classified by occupation, than after minor downsizing. The corresponding rate ratios for musculoskeletal disorders and trauma were 5.7 (4.1-8.0) and 2.7 (1.7-4.2), respectively. The effects of downsizing by workplace depended on the age distribution of the staff. When the proportion of employees who were older than 50 years was high, downsizing increased the individual risk of absence because of ill health by 3.2-14.0 times, depending on diagnostic category. When the proportion of employees over 50 years was low, downsizing had only slight effects on health. Other risk factors that increased rates of sick leave after downsizing were age over 44 years, a large workplace, poor health before downsizing, and high income. INTERPRETATION: Downsizing is a risk to the health of employees. But this risk varies according to individual factors, such as age, socioeconomic status, and health, as well as factors related to place of work, for example, size and age structure of the staff.

Absenteeism↗
PubMed1999

Cost-of-illness of neck pain in The Netherlands in 1996.

The prevalence of neck pain in the general population ranges from 10 to 15%. The complaints can result in substantial medical consumption, absenteeism from work and disability. In this study we investigated the costs of neck pain in the Netherlands in 1996 to assess the financial burden to society. The study was based on prevalence data. Data sources included national registries, reports of research institutes and health care authorities. Direct health care costs were estimated for hospital care, general practice care and paramedical care. These costs were calculated using fees. Calculation of indirect costs (absenteeism and disability) was based on the Human Capital Method (HCM). As an alternative approach the Friction Cost Method (FCM) was used. The total cost of neck pain in The Netherlands in 1996 was estimated to be US $686 million. The share of these costs was about 1% of total health care expenditures and 0.1 % of the Gross Domestic Product (GDP) in 1996. Direct costs were $160 million (23%). Paramedical care accounted for largest proportion of direct costs (84%). When applying the HCM for calculating indirect costs, these costs amounted to $527 million (77%). The total number of sick days related to neck pain were estimated to be 1.4 million with a total cost of $185.4 million in 1996. Disability for neck pain accounted for the largest proportion (50%) of the total costs related to neck pain in 1996 ($341). When applying the FCM for calculating the indirect costs, these costs were reduced to $96 million. The costs related to neck pain in 1996 in The Netherlands were substantial. Some caution should be taken in interpretation, as a number of assumptions had to be made in order to estimate the total costs. The cost structure shown in this study, with high indirect costs, has also been found in other studies. From an economical point of view it seems to be important to prevent patients from having to take sick leave and disability. One way in achieving this goal is to develop and investigate more effective treatments for acute neck pain, in order to prevent patients developing chronic pain and disability. Another option is to protect chronic patients from sick leave and disability by careful management. Thus, also in the area of direct medical costs, there may be room for cost savings by stimulating and improving cost-efficiency and cost-effectiveness of the (para)medical care. In order to deal with the lack of specific disease information, more detailed information of medical consumption, sick leave and disability is required for future cost analysis.

Absenteeism↗
PubMed2002

[Asthma among children attending kindergarten in Alsace in 1998: prevalence and medical management].

UNLABELLED: Asthma is one of the most frequent disease in childhood. The objectives of this survey were to study asthma and asthma related symptoms epidemiology in preschool children and to analyse their medical management. METHODS: A cross-sectional survey was conducted in 1998 in Alsace-France by school doctors, on a randomized sample of 2,765 pupils attending third year kindergarten. The first questionnaire accessed diagnosed asthma and asthma related symptoms history, and school absenteeism. The cumulative prevalence was estimated for diagnosed asthma on the period since birth and for asthma related symptoms unassociated with diagnosed asthma for the past 12 months. Parents who reported diagnosed asthma or asthma related symptoms unassociated with diagnosed asthma of their children were interviewed with a supplemental questionnaire examining clinical patterns, health care and asthma-related hospitalization. RESULTS: Prevalence of asthma was 6.5%. Prevalence of asthma related symptoms unassociated with a diagnosis of asthma was 7.2%. The "chesty" pupils school absenteeism was important. Most of the patients (91.3%) had a mild disease form. One third of them were not getting specific treatment. The drugs mostly prescribed were inhaled bronchodilators for acute episodes of asthma and antihistamines in prophylactic treatment. The rate of asthma-related hospitalization was 11.9%. Severe clinical pattern was statistically related to treatment and asthma-related hospitalization. CONCLUSION: Asthma prevalence is high in children attending nursery school in Alsace. This disease is still nowadays undiagnosed, underinvestigated and undertreated.

Absenteeism↗
PubMed2004

[The asthmatic child at school: difficulties encountered and proposed solutions].

Among a child out of ten is asthmatic. School absenteeism is frequent, due to an insufficient control of asthma. This insufficient control is especially evident at school where the usual risk factors of asthma are present. Allergenic risk with animals danders carried by other children, or regular practice of sports, are difficult situations for the asthmatic child. Controlling asthma, informing school and communicating with teachers, using the individualized care project, should avoid this absenteeism, which is responsible of school backwardness and difficulties in choosing careers.

Absenteeism↗
PubMed2006

Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation.

BACKGROUND: Major depression has far-reaching consequences for work functioning and absenteeism. In most cases depression is treated by medication and clinical management. The addition of occupational therapy (OT) might improve outcome. We determined the cost-effectiveness of the addition of OT to treatment as usual (TAU). METHOD: Sixty-two adults with major depression and a mean absenteeism of 242 days were randomized to TAU (out-patient psychiatric treatment) or TAU+OT [6 months, including (i) diagnostic phase with occupational history and work reintegration plan, and (ii) therapeutic phase with individual sessions and group sessions]. Main outcome domains were depression, work resumption, work stress and costs. Assessments were at baseline and at 3, 6, 12 and 42 months. RESULTS: The addition of OT to TAU: (i) did not improve depression outcome, (ii) resulted in a reduction in work-loss days during the first 18 months, (iii) did not increase work stress, and (iv) had a 75.5% probability of being more cost-effective than TAU alone. CONCLUSION: Addition of OT to good clinical practice does not improve depression outcome, improves productivity without increasing work stress and is superior to TAU in terms of cost-effectiveness.

Absenteeism↗
PubMed1986

Social learning influences on menstrual symptoms and illness behavior.

The contribution of learning to the adult experience of illness was investigated by asking 351 nursing students how their mothers reacted to menstrual symptoms and cold symptoms during their adolescence and how their mothers behaved when they themselves had menstrual symptoms. Mothers of respondents were independently asked the same questions. Nursing students who had been encouraged to adopt a sick role for menses or whose mothers modeled menstrual distress reported significantly more menstrual symptoms, clinic visits, and disability days for these symptoms as adults. Similarly, those encouraged to adopt a sick role for colds or who lived with a chronically ill person reported more clinic visits and disability days for nongynecological symptoms. Specific types of symptom reports and health care appeared to be learned: Encouragement and modeling of the menstrual sick role were more highly correlated with symptom reports, clinic visits, and absenteeism for menstrual than for nongynecological symptoms, and encouragement of the cold sick role was more highly correlated with nongynecological than with menstrual clinic visits and absenteeism.

Absenteeism↗
PubMed1998

Implementation of a self-scheduling system: a solution to more than just schedules!

AIM: To describe a model of self-scheduling and the systematic process involved in its implementation on a nursing unit in an American hospital. BACKGROUND: A change in staff work schedules became necessary when staff dissatisfaction, absenteeism, vacancies and staffing costs increased. The approach used to tackle these issues resulted in other significant outcomes such as staff-initiated projects to improve care and more time for the manager to address other issues. FINDINGS: When staff managed the project, dissatisfaction, absenteeism and costs decreased. A modified version of the self-scheduling model was replicated for other units. The gap between management and staff narrowed and staff utilized the process as a continuing education project. Applications to work on the unit multiplied. However, complaints of peer pressure, favouritism and unavailability of staff on certain shifts also emerged. CONCLUSION: Moving work environments to become more employee-friendly can facilitate transformation. Incentives to attract staff and respect for the needs of staff can translate to improved care for external customers. Recommendations are made concerning the need for nurse managers to be employee-sensitive in the interests of productivity, staff retention and progress.

Absenteeism↗
PubMed2003

The problem and management of sickness absence in the NHS: considerations for nurse managers.

AIM: This paper examines the topic of sickness absence management in the context of the healthcare sector. BACKGROUND: National Health Service (NHS) employee absenteeism is an expensive and difficult problem. Nurse managers need to assess the extent and characteristics of absenteeism, be aware of their organization's sickness policies, evaluate the effectiveness of these policies and contribute to the development of related initiatives to ensure prudent management of sickness absence. METHOD: A literature review has been undertaken, providing a broad conceptual context by which the problem of sickness absence in the NHS can be examined. The focus of this paper is to examine the accumulation of research based knowledge to provide a healthcare perspective on the problem of sickness absence management. CONCLUSION: Sickness absence management within the NHS is challenging but provides opportunities to improve the working lives of NHS employees. Sickness absence cannot be eradicated but it can be reduced by a selection of measures that reflect the uniqueness of the NHS. The many and diverse causes of sickness absence need acknowledgement, when devising strategies that can effectively provide solutions to the problems of sickness absence.

Absenteeism↗